Provider Demographics
NPI:1740616986
Name:CENTER, AMY L
Entity Type:Individual
Prefix:
First Name:AMY
Middle Name:L
Last Name:CENTER
Suffix:
Gender:F
Credentials:
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:4600 KIETZKE LN STE J-212
Mailing Address - Street 2:
Mailing Address - City:RENO
Mailing Address - State:NV
Mailing Address - Zip Code:89502-5033
Mailing Address - Country:US
Mailing Address - Phone:775-348-9047
Mailing Address - Fax:775-348-9524
Practice Address - Street 1:4600 KIETZKE LN STE J-212
Practice Address - Street 2:
Practice Address - City:RENO
Practice Address - State:NV
Practice Address - Zip Code:89502-5033
Practice Address - Country:US
Practice Address - Phone:775-348-9047
Practice Address - Fax:775-348-9524
Is Sole Proprietor?:No
Enumeration Date:2013-09-19
Last Update Date:2020-05-13
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
NVIC-13081041C0700X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes1041C0700XBehavioral Health & Social Service ProvidersSocial WorkerClinical